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Singh M, Reifman J, Rubio JE. A 3-D whole-body human thermoregulatory model to simulate cold-induced vasodilation in the hands and feet. Comput Biol Med 2024; 180:108935. [PMID: 39096610 DOI: 10.1016/j.compbiomed.2024.108935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2024] [Revised: 07/18/2024] [Accepted: 07/20/2024] [Indexed: 08/05/2024]
Abstract
The cold-induced vasodilation (CIVD) response of the human body to Arctic-like environments helps delay or prevent cold injuries to peripheral regions, such as the hands and feet. To more comprehensively predict the thermal responses of these body regions to cold stress, here we extended our previously developed and validated anatomically accurate three-dimensional whole-body thermoregulatory human model by incorporating a new phenomenological formulation of the CIVD mechanism. In this formulation, we modulated the cyclic vasodilation and vasoconstriction flow of warm blood from the body core to the peripheral regions solely by determining the heat-transfer exchange between the skin and the surrounding environment, and deactivated it when the core body temperature decreased to 36.5 °C. In total, we calibrated and validated the model using eight distinct studies involving 153 unique male subjects exposed to 10 diverse experimental conditions, including cold-air exposure of the whole body as well as air exposure and cold-water immersion of the hand or the foot. With CIVD incorporated, the model predictions generally yielded root mean square errors (RMSEs) of <3.0 °C for skin temperature, which represented a reduction of up to 3.6 °C compared to when we did not consider CIVD. Similarly, the incorporation of CIVD increased the fraction of predictions within two standard errors of the measured data by up to 63 %. The model predictions yielded RMSEs for core body temperature of <0.2 °C. The model can be used to provide guidelines to reduce the risk of cold-related injuries during prolonged exposures to very-cold environments.
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Affiliation(s)
- Manpreet Singh
- Department of Defense Biotechnology High Performance Computing Software Applications Institute, Telemedicine and Advanced Technology Research Center, United States Army Medical Research and Development Command, Fort Detrick, MD, USA; The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MD, USA
| | - Jaques Reifman
- Department of Defense Biotechnology High Performance Computing Software Applications Institute, Telemedicine and Advanced Technology Research Center, United States Army Medical Research and Development Command, Fort Detrick, MD, USA.
| | - Jose E Rubio
- Department of Defense Biotechnology High Performance Computing Software Applications Institute, Telemedicine and Advanced Technology Research Center, United States Army Medical Research and Development Command, Fort Detrick, MD, USA; The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MD, USA
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Kapoor MP, Moriwaki M, Abe A, Morishima S, Ozeki M, Sato N. Hesperetin-7- O-glucoside/β-cyclodextrin Inclusion Complex Induces Acute Vasodilator Effect to Inhibit the Cold Sensation Response during Localized Cold-Stimulate Stress in Healthy Human Subjects: A Randomized, Double-Blind, Crossover, and Placebo-Controlled Study. Nutrients 2023; 15:3702. [PMID: 37686734 PMCID: PMC10489958 DOI: 10.3390/nu15173702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 08/17/2023] [Accepted: 08/20/2023] [Indexed: 09/10/2023] Open
Abstract
Hesperetin, a citrus flavonoid, exerts vasodilation and is expected to improve endothelial function and alleviate cold sensation by activating nervous system thermal transduction pathways. In this randomized, double-blind, crossover, and placebo-controlled study, the purpose was to assess the effect of an orally administered highly bioavailable soluble inclusion complex of hesperetine-7-O-glucoside with β-cyclodextrin (HEPT7G/βCD; SunActive® HES/HCD) on cold sensation response during localized cold-stimulated stress in healthy humans. A significant (p ≤ 0.05) dose-dependent increase in skin cutaneous blood flow following relatively small doses of HEPT7G/βCD inclusion complex ingestion was confirmed, which led to a relatively effective recovery of peripheral skin temperature. The time delay of an increase in blood flow during rewarming varied significantly between low- and high-dose HEPT7G/βCD inclusion complex consumption (e.g., 150 mg and 300 mg contain 19.5 mg and 39 mg of HEPT7G, respectively). In conclusion, the substantial alteration in peripheral skin blood flow observed during local cooling stress compared to placebo suggested that deconjugated hesperetin metabolites may have a distinct capacity for thermoregulatory control of human skin blood flow to maintain a constant body temperature during cold stress exposure via cutaneous vasodilation and vasoconstriction systems.
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Affiliation(s)
- Mahendra P. Kapoor
- Nutrition Division, Taiyo Kagaku Co., Ltd., 1-3 Takaramachi, Yokkaichi 510-0844, Mie, Japan
| | - Masamitsu Moriwaki
- Nutrition Division, Taiyo Kagaku Co., Ltd., 1-3 Takaramachi, Yokkaichi 510-0844, Mie, Japan
| | - Aya Abe
- Nutrition Division, Taiyo Kagaku Co., Ltd., 1-3 Takaramachi, Yokkaichi 510-0844, Mie, Japan
| | - So Morishima
- Nutrition Division, Taiyo Kagaku Co., Ltd., 1-3 Takaramachi, Yokkaichi 510-0844, Mie, Japan
| | - Makoto Ozeki
- Nutrition Division, Taiyo Kagaku Co., Ltd., 1-3 Takaramachi, Yokkaichi 510-0844, Mie, Japan
| | - Norio Sato
- Taiyo Kagaku Co., Ltd., 800 Yamada-Cho, Yokkaichi 510-1111, Mie, Japan
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Laroche L, Bourgeois N, Lachaud L, Rispail P. Epidemiological analysis of nail aspergillosis and non-dermatophyte moulds. Criteria for the involvement of Aspergillus in 102 cases of onychomycosis at Montpellier University Hospital, France (1991-2019). Mycoses 2021; 64:1546-1553. [PMID: 34467565 DOI: 10.1111/myc.13366] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 08/17/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Moulds are often wrongly considered contaminants, not very sensitive to conventional antifungal treatments, but they may cause ungual hyphomycosis, particularly Aspergillus. Due to the lack of precise diagnostic criteria, their real impact is underestimated. OBJECTIVES Retrospective descriptive analysis of all ungual hyphomycosis cases diagnosed at Montpellier Hospital from 1991 to 2019 to: (i) determine the incidence of onychomycosis by pseudo-dermatophytes and moulds; (ii) perform an epidemiological analysis of nail aspergillosis; and (iii) provide simple criteria for mould involvement in onychopathy. PATIENTS/METHODS Data concerning 4053 patients were collected: age, sex, onychomycosis location, direct examination results, species(s) identified and fungal co-infections. Moreover, clinical data of patients with nail aspergillosis were analysed to identify potential contributing factors, and the classical criteria for mould involvement in onychopathy were critically reviewed. RESULTS A pseudo-dermatophyte or a mould was involved in nail colonisation in 17.25% of patients (men/women ratio: 0.70; mean age: 53.1 years). The identified hyphomycetes belonged mainly to the genera Fusarium (45.68%), Scopulariopsis (30.23%) and Aspergillus (16.94%). Analysis of the clinical reports of 102 patients with ungual aspergillosis (men/women ratio: 0.67; mean age: 56.3 years) identified cardiovascular (43.9%), endocrine (25.8%), cancer (19.7%) and skin (18.2%) diseases as contributing factors. CONCLUSIONS The adoption of simple and reliable criteria (ie, characteristic filaments on direct microscopic examination after periodic acid-Schiff staining, growth at seeding points in culture) allows determining the formal involvement of a mould in chronic onychopathies and avoiding possible side effects and costs of empirical or inappropriate and repetitive treatments.
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Affiliation(s)
- Laëtitia Laroche
- "MiVEGEC" and Department of Mycology and Parasitology, CNRS, IRD, University Hospital Center of Montpellier, University Montpellier, Montpellier, France
| | - Nathalie Bourgeois
- "MiVEGEC" and Department of Mycology and Parasitology, CNRS, IRD, University Hospital Center of Montpellier, University Montpellier, Montpellier, France
| | - Laurence Lachaud
- "MiVEGEC" and Department of Mycology and Parasitology, CNRS, IRD, University Hospital Center of Montpellier, University Montpellier, Montpellier, France
| | - Philippe Rispail
- "MiVEGEC" and Department of Mycology and Parasitology, CNRS, IRD, University Hospital Center of Montpellier, University Montpellier, Montpellier, France
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Reproducibility of Skin Temperature Response after Cold Stress Test Using the Game Ready System: Preliminary Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18168295. [PMID: 34444044 PMCID: PMC8392449 DOI: 10.3390/ijerph18168295] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 07/28/2021] [Accepted: 08/03/2021] [Indexed: 01/02/2023]
Abstract
The objective of this preliminary study was to determine the reproducibility of lower limbs skin temperature after cold stress test using the Game Ready system. Skin temperature of fourteen participants was measured before and after cold stress test using the Game Ready system and it was repeated the protocol in four times: at 9:00, at 11:00, at 19:00, and at 9:00 h of the posterior day. To assess skin temperature recovery after cold stress test, a logarithmic equation for each region was calculated, and constant (β0) and slope (β1) coefficients were obtained. Intraclass correlation coefficient (ICC), standard error (SE), and within-subject coefficient of variation (CV) were determined. No differences were observed between measurement times in any of the regions for the logarithmic coefficients (p > 0.38). Anterior thigh (β0 ICC 0.33–0.47; β1 ICC 0.31–0.43) and posterior knee (β0 ICC 0.42–0.58; β1 ICC 0.28–0.57) were the regions with the lower ICCs, and the other regions presented values with a fair and good reproducibility (ICC > 0.41). Posterior leg was the region with the better reproducibility (β0 ICC 0.68–0.78; β1 ICC 0.59–0.74; SE 3–4%; within-subject CV 7–12%). In conclusion, cold stress test using Game Ready system showed a fair and good reproducibility, especially when the posterior leg was the region assessed.
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Finger constrictor and thermoperceptual responsiveness to localised cooling following 5 weeks of intermittent regional exposures to moderately augmented transmural vascular pressure. Microvasc Res 2021; 137:104181. [PMID: 34015276 DOI: 10.1016/j.mvr.2021.104181] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2021] [Revised: 03/15/2021] [Accepted: 05/13/2021] [Indexed: 12/26/2022]
Abstract
PURPOSE To examine the effects of prolonged intermittent exposures to moderately increased transmural pressure on finger vasoreactivity and thermoperception to localised cooling. METHODS Eleven men completed a 5-week regimen (3 sessions·week-1; 55 min·session-1), during which the vasculature in one arm (EXP) was exposed intermittently (10-min exposure: 5-min pause) to increased transmural pressure (from +65 mmHg week-1 to +105 mmHg week-5). Before and after the regimen, finger cutaneous vascular conductance (CVC), temperature (Tavg), and thermoperception (thermal sensation, discomfort and pain) were monitored during a 30-min hand cold (8 °C water) provocation trial. The responses of the non-trained hand were examined during an additional cold trial. RESULTS After the regimen, baseline finger CVC and Tavg were higher in both hands (p ≤ 0.01). During cooling, neither finger CVC nor Tavg were modified (p > 0.05). Yet the magnitude of the cold-induced drop of CVC was augmented in both hands, and to a similar extent (p ≤ 0.02). The regimen alleviated thermal pain in both hands (p ≤ 0.02); the sensation of coldness and thermal discomfort were attenuated mainly in the EXP hand (p = 0.02). CONCLUSIONS Present findings indicate that iterative local exposures to augmented intravascular pressure do not alter finger vasoreactivity to localised cooling. The pressure training, however, might impair finger basal vasomotor tone, and aggravate the magnitude of constrictor responsiveness to cooling. The pressure training also elicits thermoperceptual desensitisation to noxious thermal stimulus. To large extent, these vascular and perceptual adjustments seem to be transferred to the cutaneous vasculature of the non-trained limb.
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Nakamoto K, Skaff PR, McCully BH, Gress TW, Mozaffari FB, Denning DA. Effects of Norepinephrine Infusion on Cutaneous Surface Temperatures of the Distal Extremities. South Med J 2021; 114:180-185. [PMID: 33655313 DOI: 10.14423/smj.0000000000001219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVES The etiology of vasopressor-induced digital necrosis is poorly understood, but the skin changes resemble those of frostbite, and it is known from experience that patients taking vasopressors have decreased digital temperatures. We aimed to examine the effects of norepinephrine use on surface temperatures of the distal extremities because there have been no studies examining this relation. METHODS Surface temperatures of all digits, palms, and soles were measured using an infrared thermometer in patients receiving different rates of norepinephrine infusion in the intensive care unit and compared with those not receiving any vasopressors. RESULTS A total of 101 measurements from 41 unique individuals were obtained. Temperature gradients between the core and the fingertips were consistently more pronounced in those receiving norepinephrine compared with those not receiving norepinephrine and increased with increasing rates of norepinephrine infusion, except with high-dose norepinephrine. Temperature gradients were more pronounced in the toes. CONCLUSIONS Norepinephrine use was associated with greater core-to-fingertip temperature gradients and were more pronounced in the toes compared with the fingers.
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Affiliation(s)
- Keitaro Nakamoto
- From the Department of Surgery and Clinical and Translational Sciences, Joan C. Edwards School of Medicine, Marshall University, Huntington, West Virginia
| | - Paulina R Skaff
- From the Department of Surgery and Clinical and Translational Sciences, Joan C. Edwards School of Medicine, Marshall University, Huntington, West Virginia
| | - Brian H McCully
- From the Department of Surgery and Clinical and Translational Sciences, Joan C. Edwards School of Medicine, Marshall University, Huntington, West Virginia
| | - Todd W Gress
- From the Department of Surgery and Clinical and Translational Sciences, Joan C. Edwards School of Medicine, Marshall University, Huntington, West Virginia
| | - Farid B Mozaffari
- From the Department of Surgery and Clinical and Translational Sciences, Joan C. Edwards School of Medicine, Marshall University, Huntington, West Virginia
| | - David A Denning
- From the Department of Surgery and Clinical and Translational Sciences, Joan C. Edwards School of Medicine, Marshall University, Huntington, West Virginia
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Lahiri B, Bagavathiappan S, Philip J. Infrared thermal imaging based study of localized cold stress induced thermoregulation in lower limbs: The role of age on the inversion time. J Therm Biol 2020; 94:102781. [DOI: 10.1016/j.jtherbio.2020.102781] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2020] [Revised: 10/27/2020] [Accepted: 11/08/2020] [Indexed: 12/15/2022]
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Eglin CM, Costello JT, Tipton MJ, Massey H. Previous recreational cold exposure does not alter endothelial function or sensory thermal thresholds in the hands or feet. Exp Physiol 2020; 106:328-337. [DOI: 10.1113/ep088555] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2020] [Accepted: 05/04/2020] [Indexed: 01/03/2023]
Affiliation(s)
- Clare M. Eglin
- Extreme Environments Laboratory School of Sport Health and Exercise Science University of Portsmouth Portsmouth UK
| | - Joseph T. Costello
- Extreme Environments Laboratory School of Sport Health and Exercise Science University of Portsmouth Portsmouth UK
| | - Michael J. Tipton
- Extreme Environments Laboratory School of Sport Health and Exercise Science University of Portsmouth Portsmouth UK
| | - Heather Massey
- Extreme Environments Laboratory School of Sport Health and Exercise Science University of Portsmouth Portsmouth UK
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Norrbrand L, Kölegård R, Keramidas ME, Mekjavic IB, Eiken O. Finger- and toe-temperature responses to local cooling and rewarming have limited predictive value identifying susceptibility to local cold injury-a cohort study in military cadets. APPLIED ERGONOMICS 2020; 82:102964. [PMID: 31604187 DOI: 10.1016/j.apergo.2019.102964] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Revised: 09/18/2019] [Accepted: 09/25/2019] [Indexed: 06/10/2023]
Abstract
The purpose was to evaluate whether a cold-water immersion test could be used to identify individuals susceptible to local cold injuries (LCI). Sixty-five healthy non-injured (N-I) subjects, and fifteen subjects, who were tested either prior to or after a LCI, sequentially immersed one hand and one foot, in 8 °C water for 30 min (CWI phase); this was followed by 15 min of spontaneous rewarming (RW phase). The LCI group showed a lower toe temperature during the CWI phase, and a lower maximum RW temperature of the fingers than the N-I group. However, digit temperatures during the CWI and RW phases exhibited low predictive values for LCI, e.g. results implied that to identify 80% of the LCI subjects, 34-78% of the N-I subjects would also be excluded. Thus, the results suggest that, in practice, hand or foot cold-water immersion tests cannot be used to identify individuals at high risk of LCI.
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Affiliation(s)
- Lena Norrbrand
- Division of Environmental Physiology, Swedish Aerospace Physiology Center, School of Engineering Sciences in Chemistry, Biotechnology and Health, KTH Royal Institute of Technology, Berzelius väg 13, SE-171 65, Solna, Sweden.
| | - Roger Kölegård
- Division of Environmental Physiology, Swedish Aerospace Physiology Center, School of Engineering Sciences in Chemistry, Biotechnology and Health, KTH Royal Institute of Technology, Berzelius väg 13, SE-171 65, Solna, Sweden
| | - Michail E Keramidas
- Division of Environmental Physiology, Swedish Aerospace Physiology Center, School of Engineering Sciences in Chemistry, Biotechnology and Health, KTH Royal Institute of Technology, Berzelius väg 13, SE-171 65, Solna, Sweden
| | - Igor B Mekjavic
- Department of Automation, Robotics and Biocybernetics, Jozef Stefan Institute, Jamova 39, SI-1000, Ljubljana, Slovenia; Department of Biomedical Physiology and Kinesiology, Simon Fraser University, 8888 University Dr, Burnaby, BC V5A 1S6, Canada
| | - Ola Eiken
- Division of Environmental Physiology, Swedish Aerospace Physiology Center, School of Engineering Sciences in Chemistry, Biotechnology and Health, KTH Royal Institute of Technology, Berzelius väg 13, SE-171 65, Solna, Sweden
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Shepherd AI, Costello JT, Bailey SJ, Bishop N, Wadley AJ, Young-Min S, Gilchrist M, Mayes H, White D, Gorczynski P, Saynor ZL, Massey H, Eglin CM. "Beet" the cold: beetroot juice supplementation improves peripheral blood flow, endothelial function, and anti-inflammatory status in individuals with Raynaud's phenomenon. J Appl Physiol (1985) 2019; 127:1478-1490. [PMID: 31343948 DOI: 10.1152/japplphysiol.00292.2019] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Raynaud's phenomenon (RP) is characterized by recurrent transient peripheral vasospasm and lower nitric oxide (NO) bioavailability in the cold. We investigated the effect of nitrate-rich beetroot juice (BJ) supplementation on 1) NO-mediated vasodilation, 2) cutaneous vascular conductance (CVC) and skin temperature (Tsk) following local cooling, and 3) systemic anti-inflammatory status. Following baseline testing, 23 individuals with RP attended four times, in a double-blind, randomized crossover design, following acute and chronic (14 days) BJ and nitrate-depleted beetroot juice (NDBJ) supplementation. Peripheral Tsk and CVC were measured during and after mild hand and foot cooling, and during transdermal delivery of acetylcholine and sodium nitroprusside. Markers of anti-inflammatory status were also measured. Plasma nitrite concentration ([nitrite]) was increased in the BJ conditions (P < 0.001). Compared with the baseline visit, thumb CVC was greater following chronic-BJ (Δ2.0 flux/mmHg, P = 0.02) and chronic-NDBJ (Δ1.45 flux/mmHg, P = 0.01) supplementation; however, no changes in Tsk were observed (P > 0.05). Plasma [interleukin-10] was greater, pan endothelin and systolic and diastolic blood pressure (BP) were reduced, and forearm endothelial function was improved, by both BJ and NDBJ supplementation (P < 0.05). Acute and chronic BJ and NDBJ supplementation improved anti-inflammatory status, endothelial function and blood pressure (BP). CVC following cooling increased post chronic-BJ and chronic-NDBJ supplementation, but no effect on Tsk was observed. The key findings are that beetroot supplementation improves thumb blood flow, improves endothelial function and anti-inflammatory status, and reduces BP in people with Raynaud's.NEW & NOTEWORTHY This is the first study to examine the effect of dietary nitrate supplementation in individuals with Raynaud's phenomenon. The principal novel findings from this study were that both beetroot juice and nitrate-depleted beetroot juice 1) increased blood flow in the thumb following a cold challenge; 2) enhanced endothelium-dependent and -independent vasodilation in the forearm; 3) reduced systolic and diastolic blood pressure, and pan-endothelin concentration; and 4) improved inflammatory status in comparison to baseline.
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Affiliation(s)
- Anthony I Shepherd
- School of Sport, Health and Exercise Science, University of Portsmouth, Portsmouth, United Kingdom
| | - Joseph T Costello
- School of Sport, Health and Exercise Science, University of Portsmouth, Portsmouth, United Kingdom
| | - Stephen J Bailey
- National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Epinal Way, Loughborough, United Kingdom
| | - Nicolette Bishop
- National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Epinal Way, Loughborough, United Kingdom.,University Hospitals of Leicester NHS Trust, Infirmary Square, Leicester, United Kingdom
| | - Alex J Wadley
- National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Epinal Way, Loughborough, United Kingdom.,University Hospitals of Leicester NHS Trust, Infirmary Square, Leicester, United Kingdom
| | - Steven Young-Min
- Rheumatology Department, Portsmouth Hospitals NHS Trust, Portsmouth, United Kingdom
| | - Mark Gilchrist
- University of Exeter Medical School and NIHR Exeter Clinical Research Facility, Royal Devon and Exeter Hospital, Exeter, Devon, United Kingdom
| | - Harry Mayes
- School of Sport, Health and Exercise Science, University of Portsmouth, Portsmouth, United Kingdom
| | - Danny White
- School of Sport, Health and Exercise Science, University of Portsmouth, Portsmouth, United Kingdom
| | - Paul Gorczynski
- School of Sport, Health and Exercise Science, University of Portsmouth, Portsmouth, United Kingdom
| | - Zoe L Saynor
- School of Sport, Health and Exercise Science, University of Portsmouth, Portsmouth, United Kingdom
| | - Heather Massey
- School of Sport, Health and Exercise Science, University of Portsmouth, Portsmouth, United Kingdom
| | - Clare M Eglin
- School of Sport, Health and Exercise Science, University of Portsmouth, Portsmouth, United Kingdom
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Gorjanc J, Morrison SA, McDonnell AC, Mekjavic PJ, Blagus R, Mekjavic IB. Ski-Everest (8848 m) Expedition: Digit Skin Temperature Responses to Cold Immersion May Reflect Susceptibility to Cold Injury. Wilderness Environ Med 2019; 30:141-149. [PMID: 30979538 DOI: 10.1016/j.wem.2019.01.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Revised: 01/01/2019] [Accepted: 01/31/2019] [Indexed: 11/25/2022]
Abstract
INTRODUCTION We tested the hypothesis that individual susceptibility to freezing cold injury might be reflected in an attenuated cold-induced vasodilatation (CIVD) response by comparing the CIVD responses of an elite alpinist with a history of freezing cold injury in the feet (case alpinist) with those of an age- and ability- matched noninjured alpinists control group (controls). According to this hypothesis, the vasomotor responses to a CIVD test of the case alpinist would represent a pathophysiological response when compared with the normal physiological response of a noninjured cohort. METHODS The case alpinist and the controls in the cohort group conducted a cold water immersion test comprising sequential immersion of a hand and foot for 5 min in 35°C water, followed by a 30-min immersion in 8°C water and a 10-min recovery period in room air. During this test we monitored the finger and toe skin temperatures. RESULTS The case alpinist had a significantly attenuated CIVD response and a lower skin temperature in all injured and noninjured digits during immersion (∼2°C lower than in the control group) and an attenuated recovery of finger skin temperatures (∼6°C lower than in the control group). CONCLUSIONS The attenuated CIVD response of the case alpinist may reflect a previously unrecognized enhanced susceptibility to frostbite. In addition to the poor vasomotor response observed in the injured toes, he also exhibited a poor vasomotor response in his noninjured fingers. The results of the present study indicate that a test of vasomotor activity during thermal stress may identify individuals predisposed to cold injury.
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Affiliation(s)
- Jurij Gorjanc
- Department of Surgery, Hospital of the Brothers of St. John of God, St.Veit/Glan, Austria.
| | | | - Adam C McDonnell
- Department of Automation, Biocybernetics and Robotics, Jožef Stefan Institute, Ljubljana, Slovenia
| | | | - Rok Blagus
- Institute for Biostatistics and Medical Informatics, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Igor B Mekjavic
- Department of Automation, Biocybernetics and Robotics, Jožef Stefan Institute, Ljubljana, Slovenia; Department of Biomedical Physiology and Kinesiology, Simon Fraser University, Burnaby, Canada
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Shilco P, Roitblat Y, Buchris N, Hanai J, Cohensedgh S, Frig-Levinson E, Burger J, Shterenshis M. Normative surface skin temperature changes due to blood redistribution: A prospective study. J Therm Biol 2019; 80:82-88. [PMID: 30784492 DOI: 10.1016/j.jtherbio.2019.01.009] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2018] [Revised: 01/08/2019] [Accepted: 01/08/2019] [Indexed: 12/15/2022]
Abstract
The continuing development and manufacture of infrared devices, together with improvements in thermal body mapping techniques have simplified surface skin thermography which is being used more extensively than ever before. Normative thermography data, however, remains incomplete. A normative blood redistribution range of skin temperatures was established for use as a reference for laboratory infrared thermography (IT), thermal body mapping, and mass fever screenings. 500 healthy volunteers participated in this prospective study. To determine the maximum range of the skin temperature changes due to the posture-related physiological blood redistribution, the volunteers were asked to keep one extremity up and another extremity down whilst lying, sitting, and standing. We obtained 6000 hand and 400 foot temperature readings. The normal temperature was 29.1 ± 0.6 °C for the middle fingers and 27.8 ± 0.7 °C for the toes. The physiological temperature change during body position changes ranged from 4 to 6 °C (fingers: 27-31 °C; toes: 26-32 °C). At normal room temperature, the surface skin temperature may vary within this range due to blood redistribution. These changes reflect the individual variability of vasomotor activity. This physiological range of temperatures should be taken into account during IT and other thermography-involved investigations.
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Affiliation(s)
- Phillip Shilco
- Science Research Department, Alexander Muss High School in Israel (AMHSI) affiliated to the Alexander Muss Institute for Israel Education (AMIIE), Hod HaSharon, Israel
| | - Yulia Roitblat
- Department of Sciences, Belkind School for Special Education, Rishon-LeZion, Israel
| | - Noa Buchris
- Dept. of Sciences, El Camino Real Charter High School, Woodland Hills, CA, USA
| | - Jacob Hanai
- Dept. of Sciences, Montgomery Bell Academy, Nashville, TN, USA
| | - Sabrina Cohensedgh
- Science Research Department, Alexander Muss High School in Israel (AMHSI) affiliated to the Alexander Muss Institute for Israel Education (AMIIE), Hod HaSharon, Israel; Science Research Department, Milken Community High School, Los Angeles, CA, USA
| | - Eden Frig-Levinson
- Science Research Department, Alexander Muss High School in Israel (AMHSI) affiliated to the Alexander Muss Institute for Israel Education (AMIIE), Hod HaSharon, Israel; Science Research Department, Milken Community High School, Los Angeles, CA, USA
| | - Jacob Burger
- Department of Anatomy and Physiology, Sharon High School, Sharon, MA, USA
| | - Michael Shterenshis
- Science Research Department, Alexander Muss High School in Israel (AMHSI) affiliated to the Alexander Muss Institute for Israel Education (AMIIE), Hod HaSharon, Israel.
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Kingma CF, Hofman II, Daanen HAM. Relation between finger cold-induced vasodilation and rewarming speed after cold exposure. Eur J Appl Physiol 2018; 119:171-180. [PMID: 30327869 PMCID: PMC6342884 DOI: 10.1007/s00421-018-4012-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Accepted: 10/08/2018] [Indexed: 12/03/2022]
Abstract
Purpose The risk for local cold injuries has been linked to poor cold-induced vasodilation (CIVD) during cold exposure and to poor rewarming after cold exposure. The purpose of this study is to establish the relation between CIVD and rewarming speed. Methods Twelve participants immersed one hand in ice water for 30 min to evoke CIVD and the other hand in ice water for 10 min to investigate the rewarming profile. The ring, middle and index fingertip temperatures were monitored during hand immersion and the resistance index of frostbite (RIF) was calculated. RIF depends on minimal (Tmin) and mean (Tmean) finger skin temperature and onset time. Rewarming was quantified using an infrared imaging system and the rewarming speed over 19 min was determined. Results Tmin (5.8 ± 3.0 °C) and Tmean (10.4 ± 3.0 °C) caused non-distinctive contributions to the total RIF-scores so that onset time (12.7 ± 3.1 min) became the dominant factor. A significant negative correlation between RIF and rewarming speed was found (rs = − 0.60, p = 0.041). Conclusions The negative relation between RIF and rewarming speed may be explained by the common observation that onset time relates to the temperature of fingertip tissue, while Tmin, Tmean and rewarming speed relates to body thermal status. The rewarming test is to be preferred over the CIVD test in terms of ease of use, but the predictive value of the rewarming test for cold injuries is limited, cannot replace the RIF since onset time of finger vasodilation is not included and should be further investigated.
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Affiliation(s)
- C F Kingma
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Van der Boechorststraat 7, 1081BT, Amsterdam, The Netherlands
| | - I I Hofman
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Van der Boechorststraat 7, 1081BT, Amsterdam, The Netherlands
| | - H A M Daanen
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Van der Boechorststraat 7, 1081BT, Amsterdam, The Netherlands.
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Gorjanc J, Morrison SA, Blagus R, Mekjavic IB. Cold Susceptibility of Digit Stumps Resulting from Amputation After Freezing Cold Injury in Elite Alpinists. High Alt Med Biol 2018; 19:185-192. [PMID: 29608373 DOI: 10.1089/ham.2017.0134] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Gorjanc, Jurij, Shawnda A. Morrison, Rok Blagus, and Igor B. Mekjavic. Cold susceptibility of digit stumps resulting from amputation after freezing cold injury in elite alpinists. High Alt Med Biol. 19:185-192, 2018. AIM The aim of the study was to assess whether previous freezing cold injury in fingers and/or toes might predispose alpinists to greater risk of further freezing cold injury, primarily due to a greater vasoconstrictor response to cold, resulting in a lower perfusion, reflected in lower skin temperature. METHODS Ten elite alpinists (N = 10; 8 male and 2 female) with amputations after freezing cold injury participated in a cold-water (8°C) immersion stress test of the hands and feet. Digit skin temperatures of amputated digits, their noninjured counterparts, noninjured digits of the affected side and noninjured digits of the corresponding side were measured. The skin temperatures were compared during three consecutive phases of the cold stress test: prewarming, cold water immersion, and passive heating. RESULTS Amputated toes cooled much faster compared to their uninjured counterparts (n = 26, p < 0.001), and attained lower skin temperatures during the cold exposure test (n = 26, p < 0.001). Higher cooling rate was observed in all the toes on the injured limb compared with the toes on the uninjured limb (n = 40, p < 0.001). In contrast to the toes, the fingers on the injured limb after freezing cold injury were warmer during cooling phase compared to uninjured fingers (n = 15, p < 0.001). CONCLUSIONS The lower digit temperatures observed in affected toe stumps during the cold stress test compared to the nonamputated toes may indicate a heightened risk of future freezing cold injury with subsequent cold exposures, as a consequence of less perfusion, reflected in the lower skin temperature. This relationship was not confirmed in the fingers.
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Affiliation(s)
| | | | - Rok Blagus
- 3 Faculty of Medicine, Institute for Biostatistics and Medical Informatics, University of Ljubljana , Ljubljana, Slovenia
| | - Igor B Mekjavic
- 4 Department of Automation, Biocybernetics and Robotics, Jožef Stefan Institute , Ljubljana, Slovenia .,5 Department of Biomedical Physiology and Kinesiology, Simon Fraser University , Burnaby, British Columbia, Canada
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Cutaneous Vascular Responses of the Hands and Feet to Cooling, Rewarming, and Hypoxia in Humans. Wilderness Environ Med 2018; 29:45-55. [DOI: 10.1016/j.wem.2017.11.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2017] [Revised: 10/13/2017] [Accepted: 11/07/2017] [Indexed: 11/23/2022]
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